Clinical Analysis Of Allergenic Factors For Asthma Patients In Taiyuan And Surrounding Areas

Objective:This study investigates the characteristics of Asthma-inducing allergens in Taiyuan and surrounding areas by serum allergen testing and patient's age,gender,body mass index,family history,and lung functions,as well as the air pollution status.Ultimately,this study aims to apply the allergen-specific immune therapies in clinical settings,improving patients' life qualities,reduce the asthma attack and lower the economy burden of social and family.Methods:Used western blot method to the 213 patients who were confirmed as acute asthmatics patients with mild-to-moderate in Shanxi Medical University the first hospital breathing section during November 2014 and October 2016.The patients were treated for serum allergy original(including Ingestion and inhalation allergen).According to the results is divided into allergy original positive group and allergy original negative group while collect the general information of the two groups of asthma patients and lung function index: FEV1%Pre,and FEV1/FVC%,and PD20,and PEF,analyzing and comparing the relationship among the allergy origin,age,gender,BMI,family history of allergy disease,lung function and air pollution during 1-3 days within average of PEF.In the allergen-positive group,60 patients with asthma with dust mite allergens were selected and then randomized into the control group which given routine treatment and the observation group with given routine treatment for allergic factors(including avoidance of contact,desensitization therapy),the desensitization treatment in theobservation group should be started after a month's routine treatment of asthma control,and then after 6 months make an evaluation of bronchial asthma treatment and allergy treatment efficacy.Results:1.Characteristics of allergic factors in patients with bronchial asthmaSerum specific IgE antibody and total IgE antibody in patients who diagnosed with bronchial asthma show:158 cases were positive,the positive rate was 74.2%,the positive rate of single allergen positive was 76(48.1%),the positive rate of more than two kinds of allergen positive patients were 82(51.9%).There are 8 cases of total Ig E<100IU/m L(5.1%),100-200IU/m L patients were 27 cases(17.1%),>200 IU/m L patients were123cases(77.8%),total Ig E positive rate is 74.2%;the positive rate of inhaled s Ig E(65.8%)is higher than that of food intake s Ig E(9.5%).2.The relationship between positive rates of asthma1)Patients and general condition of patients with asthma.There was no significant difference between allergen positive group in asthmatic patients and allergen-negative group in age,BMI(t=1.609,P=109;t=0.915,P=0.361);2)There was no difference in the positive rate of allergens in the patients with asthma in different age(adolescent,middle-aged and old)(the positive rate was71.0%,78.0%,94.1%,X2=4.683,P=0.096);3)The positive rate of allergen was 72.4% in male patients and the positive rate of allergen was 75.4% in female patient.And the positive rate of allergen in female patients was higher than that of male patients.The difference between the two has statistically significant(X2=0.239,P=0.636);4)The patients with asthma in the positive allergens is related to the familial history of allergic diseases(X2=92.031,P<0.05).3.The relationship between positive rate of allergen in asthmatic patients and pulmonary function index.The PD20,FEV1%Pre,FEV1/FVC% in allergen positive group is under than the allergen-negative group,the difference between them two has statistically significant(t=-8.503,P<0.05;t=-2.384,P=0.019;t=-2.932,P=0.004).4.The impact of air pollution on asthmatic patients.The average PEF by using peak flow meter for the allergen positive group in 1-3days with moderate to severe air pollution is(196.95±46.89)L/min.The average PEF for the allergen negative group during the same air pollution is(213.98±46.12)L/min.The average PEF of the allergen positive group was significantly under than the average PEF of the allergen-negative group.And the difference has statistically significant(t=-2.349,P=0.021).5.Observation of therapeutic efficacy of allergic factors.Analyzing the results of objective PEF and subjective ACT of the patients who received Allergic factor Therapy and the patients who only received routine treatment after 6 months: the ACT score in the observation group increased(3.30 ± 1.97)significantly greater than the control group(2.10 ± 1.35).The difference of the two is significantly different(t=2.755,P<0.05);PEF for the observation group is(86.0±5.8)L/min is significantly greater than the control group(80.6±5.4)L/min.And the difference has statistically significant(t=3.727,P<0.05).Conclusion:1.Dust mites,wormwood and ragweed are common allergens causing asthma in Taiyuan and the surrounding areas;2.The positive of allergen in asthmatic patients may be related to the family history of allergic diseases and pulmonary function indexes,irrespective of sex,age and BMI;3.The patients with asthma in the positive allergens may have greater impact when air was polluted;4.In response to allergic factors and to avoid exposure to allergens,after allergen desensitization treatment can better improve the lung function,reduce acute episodes,thus improve the quality of patients' life,and reduce the social and family economic burden.